Opposition Evaluation

Meddling with Medicine:An Evaluation of the ACA and its OppositionLearning Team AFebruary 2, 2015Ali Akbar, Ryan Mayes, Matt Miller, Katelyn Murray, Adrienne RiosPOL 443 Wealth and Power in America Barbara KitemeAs U.S. citizens, were all aware of the recent controversy surrounding the Affordable Care Act. This controversial piece of legislation has a defined groups of supporters, but more and more often, ACA supporters are being out canvased by the largely-Republican opposition group. This presentation will provide an evaluation of both the ACA supporters and their opposition, examining the conflict from the viewpoints of pluralism, state autonomy, and elitism.

The ACA and Debate - RyanRepublicansRepealing ObamacareDemocratsBetter AmericaNPR Debate

According to the Republican platform, the ACA is a violation of the constitutional rights of each American. Republicans claim that Obamacare was never really about healthcareit was about power (Republican National Committee, 2012-2014, para. 8). Republicans leave no room for debate when the unmovable stance of the party is to repeal the ACA. The platform continues by stating that the first action of a newly elected Republican president will be to repeal the Affordable care act (2012-2014).

Democrats, on the other hand, believe ACA is a building block for future strength of American as it provides better health care for all Americans (DNC Services Corporation, 2015). They will also not budge on their stance and do not allow Republican arguments to sway the partys opinion.

Debate is simply not taking place between the Republican Party and the Democratic Party. Neither side will move from its hardline stance. It has become a case of either/or as both sides avoid debating the issue. Debates are taking place, but not by policymakers. NPR held a debate over ACA in January of 2014. The debaters were not Republican or Democratic Party members but two physicians and two columnists (NPR, 2014). Although they brought light to the arguments, they do not hold power to change the debate on a National scale.

Photo Reference: Francis, D., & Pianin, E. (2013, July 1). 7 ways businesses can dodge Obamacare. Retrieved from http://www.inc.com/the-fiscal-times/seven-ways-businesses-can-avoid-obamacare-affordable-care-act-health-care.html3The ACA and Policy Decisions - Ryan

Bad-mouthing the ACA.Government shutdown.Other policies are ignored.The ACA has divided Democrats and Republicans not only in debate but on policy. For policymakers, the ACA has created many standstills and even a government stoppage. Republicans have nicknamed ACA Obamacare which stands as a derogatory term aimed at both the Affordable Care Act and President Obama. On the Republican Partys website, the GOP states that one of its main goals is repealing Obamacare (Republican National Committee, 2012-2014, para. 8). This stance has led to Republicans, across the board, refusing to cooperate with Democrats because of the existence of ACA. In September of 2013, Republican House members refused to pass the budget if the ACA was not revoked. Democrat leaders would not participate in talks and the government was temporarily shut down (Lewis, 2013).

When the government cannot function because of a shutdown, policy becomes a second thought. Instead of working to fix the problem, sides refused to work and policymakers cannot do what the American people need. Other issues get sidelined and needs sit unmet.

Photo Reference: Palmero, J. (2013, September 23). House Republicans: Yee-haw! were shuttin down the govmint! Retrieved from http://www.laprogressive.com/shut-down-government/

4ACA Opposition in Consensus with Public OpinionDonations to the Republican Party Increase

States Push Back Democratic Party Changing Stance

Supreme Court ChallengesHealth insurance companies continue to work closely with the governmental representatives to assist the signing of people for the ACA while funding the Republican Party to fight the ACA. The Public Action Committee, Americas Health Insurance Plans, donated $162,500 to Republicans during the period of ACA adoption while only providing the Democrats $115,500 (Viebeck, 2014). The increase in support for Republican candidates demonstrates the willingness of the Health Insurance Industry to fight against the ACA. As of December of 2012, 26 States and the National Federation of Independent Business began challenging the constitutionality of the ACA (The Heritage Foundation, 2012). The fact that individual states are pushing back against the ACA provides evidence of oppositional consensus with public opinion. Although the Republican Party provides opposition through representation in Congress, when more than half of the states begin to provide direct opposition the stance on the issue is relatively clear.Through encouragement through oppositional parties like The Heritage Foundation, 16 Democratic Senators, who initially supported the ACA, petitioned the Senate Majority Leader (H. Reid) to delay the acts job killing tax on medical devices (The Heritage Foundation, 2012). The ACA is becoming more unpopular as the general public begins to learn more about the taxes and specifications the act entails.Multiple states and organizations began challenging the legal aspect of the ACA up to the Supreme Court. However, the Supreme Court ruling on the ACA maintains the legitimacy of the ACA because of the tax implications to non-participants versus defining the act as a mandate (The Heritage Foundation, 2012). This decision strikes a significant blow to the ACA opposition and continues the ACA as law until the lawmaking body of government rectifies the unpopular aspects of the law.

5Public versus Political InterestsLobbyists, Politicians, and Millions of Dollars

Large Business Obligations

Small Business Obligations

The Un- or Under-Insured

The Republican Party opposes the ACA because of the act stipulations regarding taxes, healthcare provider provisions, the potential to reduce health care quality, and the negative impact on small businesses (GOP, 2015). The Democratic Party is supportive of the ACA because the act provides affordable health care options to all Americans, eliminates discrimination of pre-existing conditions, and provides a large health care tax cut for the middle class (Democratic National Committee, 2015). However, Republican Party members benefited from $243 million dollars in lobbyist money during the fight of health care reform (Flynn, 2013). The opposition to the ACA appears to be focused on protecting the health care industry more so than the population of the U.S. in need of affordable health care.The large business opposition to the ACA regards increasing tax rates and the negotiating capacity large businesses maintain when dealing with insurance companies. The large health care providing companies lobbied against the ACA because of the potential for lost revenue (Flynn, 2013). The small business opposition to the ACA regards increasing tax rates, requirements to provide health care coverage, and the ability to comply with the law and remain profitable. Small business owners do not maintain the same financial flexibility of large corporations and may not be able to maintain compliance and financial stability (Flynn, 2013).The uninsured or underinsured general public provides a mix of emotions and stances on the ACA. Although some of this group is happy to see the elimination of discriminatory practices of insurance companies against those with pre-existing conditions, some are beginning to question the affordability of the coverage. The tax implications for those unable to afford health care under this act are rising, even with the proposed tax cuts to middle-class persons. Some Americans still believe that health insurance is simply an individual choice and should not be a mandate by the government. Governmental mandates is a key point to states challenging the Constitutionality of the ACA (The Heritage Foundation, 2012).

6Pluralism, State Autonomy, ElitismFactions in SupportEverybody eventually a patientBase care on preventative servicesCommon-sense solution neededBeneficial for all involvedQuality, affordable coverageNo lifetime limits (The White House. (n.d.). Pre-existing conditions okay (The White House. (n.d.). Regardless of income

PluralistsHaving choices when losing a job, switching jobs, moving, or becoming ill gives people choices instead of living without insurance. Obtaining insurance with a multitude of options will help people choose what is best for their situation. Younger individuals may choose a higher deductible plan since they may have few health issues. Older people may choose lower deductibles and testing. Keeping people healthier throughout their lives may keep the Medicare system used less. Many possibly wait until Medicare age to address health issues (Hoffman, A. K., (2011)

State AutonomySociety may choose their own version of reform. This may be achieved by taking the best of the government reform and adding the real world items people think remains important to their healthcare. Involving foundations and other self-serving influences, gathering support of the idea. Showing that the masses prefer the alternative should gather attention.

ElitistsSurely some Elitists should feel their nerve that the well-off can afford the best care and others suffer for the simple reason of income. A healthier workforce should make companies stronger possibly becoming more profitable to the upper class and elite. This could come from company ownership or through investments.

7Pluralism, State Autonomy, ElitismFactions in OppositionTrust issues Insurance industry and governmentPrefer market solutions Not government involvementMore choicesNot one size fits allCurb insurance company spendingProfits originate from spending more

PluralistsPluralists may feel better nutrition, clean water, and sanitation systems may work. Taxing items that lead to poor health may also work. This would include tobacco products, sugared soft drinks, and fast food. Pluralist may believe changing bankruptcy policies involving health care costs will give people some security. Promoting health through mandatory free or low-cost testing through prevention of cancers and other illnesses. Prevention will help save money for insurance companies as well as patients. Using reimbursements paid to individuals for promoting ones health, may work too. Many options exist before government intervention (Hoffman, A. K., (2011)

State AutonomyThe population may prefer a different path to reform rather than government intervention. Many prefer the government to stay out of reform all together because of the problems with other government programs. Think tanks and influence groups may help the public present something better for everybody.

ElitistsElitists may not agree to the reform because this forces many profit-making companies to reduce overhead and spending. Many of the elitists have investments in companies because of the profits they earn. This would force this class of individuals to look elsewhere for earnings reducing money invested in the businesses through stock purchases within the healthcare industry. Insurance companies may need to turn to brokers to reach the public and Human Resource managers rather than heavy advertising (University of Phoenix. (2013). Forcing the upper class and elite to use the same facilities as the poor to interact may not end well. This may become the only time people from either end of the money spectrum interact. Will the elitists feel they deserve more than the poor even though both will pay similar premiums?

8The Pros and Cons of the Affordable Care Act

Pros:

Uninsured Americans now have access to affordable health care, some of which may qualify for free or low cost benefits. In some cases, the federal government will also provide help with out of pocket cost by cost sharing reduction subsidies for certain health plans. The health insurance5marketplace provides a one stop shop that allows individuals to compare insurance coverage from many different private insurance companies (ObamaCare: Pros and cons of Obamacare, 2014).

Cons:

High income earning Americans will pay higher taxes to offset the cost of the ACA. Unless an exemption is granted, individuals must obtain health care coverage or face a tax penalty for each month of the year the individual was without health insurance. Although one of the main focuses of the ACA was to ensure all Americans had health insurance, 12.9% of Americans are still uninsured (ObamaCare: Unisured rates, 2015).

Photo Reference Hochstadt, S. (2013). The website that didnt work. Retrieved from http://www.laprogressive.com/obamacare-website/.Public Health Watch. (2014). Obamacare opponents beware: 15 signs the affordable care act is working. Retrieved from https://publichealthwatch.wordpress.com/2014/06/22/obamacare-opponents-beware-15-signs-the-affordable-care-act-is-working/9Resolution

The Affordable Care Act is a current issue that Democrats and Republican have yet to come to a consensus on. This polarizing issue was in part responsible for a federal government shut down in 2013. With so much disagreement it is difficult to sift through the different points of view, what is valid information and what should be disregarded. For the majority of Americans the ACA will provide better health care that is affordable and non discriminating. Although government mandated health care coverage may be viewed as unconstitutional by some, however; the ACA is in effect helping to change the American view that quality healthcare is only available to those who can afford to pay for it. All major medical insurance is guaranteed issue, meaning you cant be denied coverage for any reason (Benefits of Obamacare: Advatage of Obama care, 2015).

Photo Reference King, M, 2013. Obamacare 101. Retrieved from http://www.austinchronicle.com/news/2013-09-27/obamacare-101/10ReferencesDNC Services Corporation. (2015). Issues: Health care. Retrieved January 29, 2015 from http://www.democrats.org/issues/health_careLewis, P. (2013, September 29). US government shutdown: House votes to delay Obamacare law. Retrieved from http://www.theguardian.com/world/2013/sep/29/us-government-shutdown-house-delay-obamacareNPR. (2014, January 22). Debate: Is the Affordable Care Act beyond repair? Retrieved from http://www.npr.org/2014/01/22/264532710/debate-is-the-affordable-care-act-beyond-repairRepublican National Committee. (2012-2014). Renewing American values. Retrieved January 29, 2015 from https://www.gop.com/platform/renewing-american-values/

Hoffman, A. K., (2011) Three Models of Health Insurance: The Conceptual Pluralism of the Patient Protection and Affordable Care Act University of Pennsylvania Law Review, Vol. 159, 2011; UCLA School of Law Research Paper No. 11-19. Available at SSRN: http://ssrn.com/abstract=1851852

References contdUniversity of Phoenix. (2013). With Change Coming, Aetna Targets Employers. Retrieved from University of Phoenix, POL/443 website

Democratic National Committee. (2015). Health Care. Retrieved from: http://www.democrats.org/issues/health_careFlynn, M. (2013). Health Care Industry Spent $243 Million in 2013 Lobbying ObamaCare. Retrieved from: http://www.breitbart.com/big-government/2013/09/23/health-care-industry-spent-243-million-already-in-2013-lobbying-obamacare/

References contdGOP. (2015). Obamacare Regulations and Rules. Retrieved from: https://www.gop.com/topic/obamacare-obamacare-regulations-and-rules/?content_filter=researchObamaCare Regulations and RulesObamaCare Facts. (2015, January). Obamacare facts: Affordable care act, health insurance marketplace. Retrieved from http://obamacarefacts.com The Heritage Foundation. (2012). Annual Report 2012. Retrieved from: http://thf_media.s3.amazonaws.com/2012/pdf/2012AnnualReport.pdfViebeck, E. (2014). ObamaCare Partners give to the GOP. Retrived from: http://thehill.com/policy/healthcare/217368-obamacare-partners-give-to-the-gop